PATIENT/CAREGIVER INSTRUCTIONS
Oxygen Cylinder and
Concentrator Systems
Follow all warnings and instruction labels on
medical devices.
To obtain a copy of the manufacturer’s product manual,
visit us at apria.com
Table of Contents
Oxygen. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Oxygen Safety Precautions . . . . . . . . . . . . . . . . . 2
Handwashing Technique . . . . . . . . . . . . . . . . . . . 4
Care of Your Oxygen Tubing . . . . . . . . . . . . . . . . 4
Physical Problems . . . . . . . . . . . . . . . . . . . . . . . . . . 5
OXYGEN CYLINDER
Your Oxygen Cylinder System . . . . . . . . . . . . . 6
Pediatric Applications . . . . . . . . . . . . . . . . . . . . . 6
Your Stationary Cylinder System . . . . . . . . . . 7
Your Portable Cylinder System . . . . . . . . . . . . 9
Oxygen Cylinder Supply Times . . . . . . . . . . . 11
Replacing Your Cylinder . . . . . . . . . . . . . . . . . . 12
Reordering Oxygen . . . . . . . . . . . . . . . . . . . . . . 14
Oxygen Cylinder Troubleshooting. . . . . . . . 15
OXYGEN CONCENTRATOR
Your Oxygen Concentrator . . . . . . . . . . . . . . . 16
Operating Your Oxygen Concentrator . . . 16
Cleaning and Maintenance Procedures . . . 18
Care of Your Humidifier Bottle . . . . . . . . . . . . 19
Oxygen Concentrator Troubleshooting . . . 20
Travel Tips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Feedback on Our Services . . . . . . . . . . . . . . . . . 22
Oxygen
Oxygen is a prescribed drug. Never increase
or decrease your oxygen flow rate without
the specific approval of your physician.
If your physician changes your oxygen
flow rate or hours
of use, notify
Apria Healthcare
immediately.
All people need
oxygen in order to
live. Oxygen is a gas
that we can’t see,
taste, or smell, yet is
always there in the air
The respiratory system
which surrounds us.
The amount of oxygen in the air is always 21%.
Oxygen is inhaled into our lungs and is then
transported through the blood to all parts of
the body. Oxygen helps convert food to heat
and energy. This process is called metabolism.
When the respiratory system is working
properly, oxygen is inhaled and transported
to the cells with ease. Carbon dioxide, a
by-product of metabolism, is then returned
to the lungs and exhaled.
Using Supplemental Oxygen
The 21% concentration of oxygen in the air
around us is enough for people with normally
functioning lungs and heart. However, a
person with lung or heart problems may
often benefit from breathing air which has
a higher concentration of oxygen in it.
When the body does not get enough
oxygen, a person may experience difficulty
in breathing, fatigue, loss of memory,
headaches and/or confusion. Using
supplemental oxygen may help provide
relief from these symptoms.
©2016 Apria Healthcare Group Inc. Apria Healthcare with its accompanying logo is a registered trademark of Apria Healthcare Group Inc.
OXYGEN CYLINDER AND CONCENTRATOR SYSTEMS
1
Oxygen Safety Precautions
Oxygen can be used safely when
handled and stored properly.
By using the following safety
guidelines, you will create a very
safe environment when you use
your oxygen.
Cylinders
Warning:
contain oxygen which is under
high pressure. The oxidizing
gas vigorously accelerates
combustion (a fire) if the oxygen
inside the cylinder is near fire or
open flames. (See “Warning: Heat” below.)
For safety reasons, it is recommended that
you install smoke alarms outside each
sleeping area and on each level in the home.
Fire extinguishers are also recommended.
Warning:
Heat
Keep oxygen equipment and oxygen
tubing at least five (5) feet away from
any source of heat.
Keep the oxygen equipment and oxygen
tubing away from open flames, stoves, space
heaters, or any source of heat.
Cylinders under high pressure may be
explosive if exposed to extreme heat.
Warning:
Grease/Flammables
Never use grease or oil on oxygen
equipment.
Keep oxygen equipment away from all
flammable materials such as oil, grease,
2
aerosols, paints, gasoline and solvents. Hand,
hair or body lotions should not come in
contact with oxygen equipment.
Warning:
Cylinder Stability
Secure cylinders against falling or
striking other objects at all times, even
when traveling.
Compressed gas oxygen is stored in
cylinders under very high pressures.
For this reason, cylinders must be secured
from falling or rolling at all times. For
safety purposes, a cylinder should be used
and transported in a specifically designed
cylinder cart and/or carrying case. For
information on securing cylinders for storage,
see the “Storage” section on page 3.
The weight of the cylinder may cause injury
and damage property if it were to fall on
someone or something. The cylinder valve
could also be knocked off if the cylinder
were to fall over. The high pressure coming
out of a broken valve opening could then
cause the cylinder to move about the room
in a destructive, uncontrolled manner. If this
happens, move away from the cylinder and
call Apria Healthcare immediately. Please
ventilate the room.
No Smoking
Do not permit
smoking in the
same room as
your oxygen
equipment. This
includes electronic
cigarettes (e-cigarettes).
APRIA HEALTHCARE PATIENT/CAREGIVER INSTRUCTIONS
Place “No Smoking” signs on the front door or
in a front window of your residence. Apria also
encourages you to post “No Smoking” signs in
the room where your equipment is in use.
cylinders must be secured from movement
at all times. Cylinders may be stored either
lying down (unstacked) or upright in an
approved oxygen cylinder storage rack.
It is possible for you to be in a large room
such as a restaurant where smoking is
permitted as long as lighted smoking
materials are not within five (5) feet of you.
Nevertheless, when visiting restaurants,
always ask to sit in the no smoking section.
Please store and care for your oxygen
cylinders and concentrator carefully.
Do not store oxygen equipment in an
unattended vehicle.
Cooking
It is best to cook using a microwave oven
only. Cooking on a gas or electric stove is
not recommended.
Storage
Do not place your oxygen equipment in
a small or unventilated storage area.
Do not place oxygen equipment in a small
storage area such as a closet or car trunk. Any
venting oxygen could create a fire hazard.
Oil-Based Toiletries and Small
Appliances
When using oxygen, never use oil-based
face or hair creams, a hair dryer or an
electric razor.
It is possible in certain conditions that the
combination of oxygen, oil-based toiletries,
and a spark from an electrical appliance
such as an electric blanket, hair dryer,
electric razor or heating pad, could ignite
and cause burns. Never use oil-based hair
lubricants, face and hand lotions, petroleum
jelly products, or aerosol sprays. Always use
water-based cosmetics or creams.
At Home
Cylinders may be stored either lying down
(unstacked) or upright in a specially designed
oxygen cylinder base or cart. When storing
portable oxygen cylinders, the cylinders must
be secured at all times from falling, if upright,
or from rolling, if lying down. It is possible to
store cylinders under a bed, if the area is well
ventilated and the bedding does not extend
to the floor.
While Traveling
When traveling with oxygen cylinders, the
OXYGEN CYLINDER AND CONCENTRATOR SYSTEMS
Furniture Polish
Clean the concentrator surface with a
damp cloth. Never use wax, spray or
furniture polish to clean any type of
oxygen equipment.
Extension Cord
Do not use
an extension
cord with the
concentrator.
3
Electrical Outlet
2. Use soap.
Never plug the concentrator into an outlet
that is being used to power
other major appliances.
3. Scrub hands for 20 seconds using a
rotary motion and friction. Wash:
• Back and palm of each hand
• Between all fingers
• Fingernails
Need a timer? Hum the “Happy
Birthday” song from beginning to
end twice.
Home Address
Make sure your home
address can be easily seen
from the street during both
day and night.
Check to see that your address numbers are
easy to spot and read from the street. If you
are expecting a night delivery or visit, turn
on the porch light. This will allow all Apria
Healthcare and emergency personnel to
locate your residence easily.
Emergencies and Natural Disasters
In the event of an emergency or natural
disaster, follow the internet, radio or
television emergency instructions broadcast
by your local authorities.
Handwashing Technique
Thorough
handwashing must
be done prior to
all procedures.
Contaminated,
dirty hands are
one of the most
common sources
of infection.
5. Dry on clean towel or with a
paper towel.
For additional good health habits, visit our
Patient Education section on apria.com.
Care of Your Oxygen Tubing
Minimal care
is required of
your oxygen
tubing and
Oxygen Tubing
Nasal Cannula
nasal cannula
or oxygen mask. We recommend that once or
twice during the day, you remove the cannula
or mask and wipe it clean with a damp cloth.
You should discard and replace your nasal
cannula or oxygen mask every two weeks.
Discard and replace your tubing every
90 days.
Do not use alcohol or oil-based
Warning:
products on or near your cannula or mask.
Wash hands for 20 seconds
1. Wet your hands thoroughly with
warm water.
4
4. Rinse your hands under the
running water.
Concentrator System
Moisture may accumulate inside the
oxygen tubing, especially if you are using
APRIA HEALTHCARE PATIENT/CAREGIVER INSTRUCTIONS
a humidifier bottle. Excess moisture may
reduce oxygen flow. If this happens you
should try the following steps:
You should use your back-up/portable
oxygen system while refilling and cleaning
your humidifier bottle.
Step 1: Remove the humidifier bottle from
the concentrator.
Step 2: Attach a
nipple adapter to
backup cylinder.
Step 3: Remove the
oxygen tubing from
the humidifier bottle
and attach it to the
nipple adapter on your
backup tank.
Step 4: Open the flow
on your oxygen backup
tank, and allow the
oxygen to run directly
through the tubing.
Within a few minutes,
the tubing will be dry.
Step 5: When
the tubing is dry,
disconnect it from
backup tank. Reconnect
the humidifier bottle
to the concentrator
and reattach the
oxygen tubing to the
humidifier bottle.
Nipple
Adapter
Step 6: Check the liter flow to make sure the
oxygen is flowing at the prescribed level.
Note: If excess moisture is a recurrent
problem, be sure to call your Apria location
to request a “water trap.”
Physical Problems
If you experience any of the following
problems, call your physician:
• Increased shortness of breath
• Chest pain
• Fever or chills
• Increased wheezing
• Increased mucus production
• Mucus becomes thicker
• Change in mucus color
Attach nipple adapter
to outlet of oxygen
regulator
• Headaches
• Loss of appetite
• Increased cough
• Swelling in your ankles or around
your eyes
• Weight gain overnight
• Feeling dizzy or sleepy
• Any change in physical sensation after
taking a new medication
If you experience severe physical problems,
call 911 or your local emergency services.
Attach oxygen tubing
to nipple adapter
OXYGEN CYLINDER AND CONCENTRATOR SYSTEMS
If you experience any physical change,
call your physician.
If you are having trouble with your
equipment, call Apria Healthcare.
5
Your Oxygen Cylinder
System
With this system, oxygen gas
is pressurized to a high
level and stored in steel or
aluminum cylinders. The
pressure is measured in pounds
per square inch (PSI). The higher
the pressure, the greater the
amount of oxygen which can
be compressed into the space
of the cylinder.
Regulator
Cylinder
Cylinder
stand
Oxygen Tubing
Nasal Cannula
of oxygen. At 2 liters per minute,
this is enough oxygen for over
24 hours of continuous use.
Patients needing a portable
supply of oxygen use a smaller
lightweight system. The weight
of these portable cylinders
ranges from 3.5 to 18 pounds.
Your cylinder system consists of
the following parts: the cylinder
M cylinder system
which stores the pressurized
There are several sizes of
oxygen, the cylinder stand which stabilizes
portable oxygen cylinders. The most common
the cylinder to prevent accidental tipping,
are the M6 (B), ML6, and E cylinders.
a regulator which controls the flow of oxygen
The M6 or B cylinder is the smallest of these
from the cylinder and, if recommended,
cylinders. It is made of aluminum and is almost
a humidifier bottle.
always used with an oxygen conserving
The oxygen is delivered to you through a
device. When used in conjunction with an
nasal cannula or face mask. The tubing on the
oxygen conserving device, the M6 cylinder at
cannula or mask is attached to the outlet on
a setting of 2 will last approximately 4 hours.
the regulator. Sometimes, an extra length of
The M6 cylinder is usually carried in a carrying
tubing may be provided. This will allow you
case with a shoulder strap. The E cylinder is
to move about at a farther distance from
the largest of the portables and is often used
your cylinder.
with a wheeled cart.
Oxygen cylinders are available in various
sizes. Depending upon the size of the cylinder
and the amount of oxygen you use, the
oxygen will last for different periods of time.
The most commonly used large cylinder is the
M cylinder. This cylinder weighs approximately
50 pounds and is meant to be used as a
stationary source. It contains over 3450 liters
6
Pediatric Applications
If the prescribed flow rate of oxygen is less
than one liter per minute, a special pediatric
regulator is used. The pediatric regulator has
settings for very low flows, such as 1/16, 1/8
and 1/4.
APRIA HEALTHCARE PATIENT/CAREGIVER INSTRUCTIONS
Pressure Gauge
Nipple Adapter
Flow Selector
Regulator on a stationary oxygen cylinder
Clear dust from connector
orifice (Step 2)
Your Stationary Cylinder
System
The regulator on a stationary cylinder system
consists of the pressure gauge which tells
you how much oxygen is left in the tank and
a flow selector which indicates the flow rate
of oxygen.
Operating Your Large Stationary
Cylinder System
The following step-by-step instructions will
help you operate your cylinder system.
Attaching the Regulator to a Full
Cylinder
To attach the regulator assembly to a
full cylinder, follow the steps below.
Caution: Make sure the valve
opening is not directed at yourself
or anyone else when opening
the cylinder.
Step 1: Remove the dust cover from
the cylinder outlet.
Attach regulator to cylinder
(Step 3)
Step 2: Open the cylinder valve slightly by
turning counterclockwise. This will blow off
any dust in the orifice of the cylinder outlet.
Close the valve tightly.
Step 3: Attach the regulator to the cylinder
by threading the regulator connector nut
clockwise on the cylinder outlet. Tighten
firmly with a cylinder wrench.
Step 4: If not already present, attach a nipple
adapter to the regulator outlet and attach the
oxygen tubing to the nipple adapter.
Turning On Your Oxygen
Step 1: Slowly open the cylinder valve
by turning
counterclockwise.
(Never open the
cylinder quickly as
this may damage
the regulator
and/or cause heat
buildup in the
regulator.) The
needle in the
Turn counterclockwise to open cylinder valve
OXYGEN CYLINDER AND CONCENTRATOR SYSTEMS
7
pressure gauge
will register the
amount of oxygen
in the cylinder. A full
cylinder registers
Pressure gauge on regulator
approximately 2,000
pounds per square inch (PSI).
Step 2: Adjust the flow selector knob until
the number in the window is your prescribed
flow rate number.
Your physician has prescribed
Warning:
the oxygen flow rate for you. Never change
the flow rate without instructions from
your physician. If you are confused about
the prescribed setting, please consult your
physician or Apria Healthcare immediately.
Step 3: Fit the nasal cannula or the oxygen
mask to your face so that it is comfortable.
Follow the instructions below for either the
nasal cannula or the oxygen mask, depending
on what your physician has directed you to use.
Nasal Cannula
• Insert the two prongs of the cannula into
your nostrils. Make sure the prongs face
upward and curve into your nostrils.
• Slide the tubing over and behind
each ear.
Flow Selector Knob
Flow Selector Window
Turn flow selector knob to
adjust oxygen flow (Step 2)
• Adjust the tubing to fit comfortably under
your chin by sliding the adjuster upward.
Be careful not to adjust it too tightly.
Oxygen Mask
• Place the oxygen mask over your mouth
and nose.
• Slide the loose elastic strap over your
head and position it above your ears.
• Pull the end of the elastic on each side of
the mask until the mask fits comfortably.
• Pinch the metal nose strap to fit snugly
around your nose. This will prevent
oxygen from blowing into your eyes.
Note: Do not use an oxygen mask if your
physician prescribed a nasal cannula.
Oxygen masks must only be used with liter
flow rates of five liters (or more) per minute.
Always use your oxygen at the proper flow
rate for the number of hours each day your
physician has prescribed. Contact Apria
Healthcare if your contents pressure is
500 psi or lower (in the red zone).
Turning Off Your Oxygen
Adjust nasal cannula
8
Adjust oxygen mask
When you are finished using your oxygen
cylinder, turn off your cylinder system by
following these steps:
APRIA HEALTHCARE PATIENT/CAREGIVER INSTRUCTIONS
Step 1: Remove the nasal
cannula or oxygen mask.
DO NOT use the cylinder and regulator
without the washer.
Step 2: Turn the
cylinder valve
clockwise until
snug. (Do not
overtighten.)
Most smaller portable cylinders are used with
a carrying case. The larger portable cylinder
may be used with a wheeled cart.
• This stops the
flow of oxygen
from the cylinder.
The regulator consists of the pressure gauge,
which tells you how much oxygen is left
in the cylinder, and a flow selector, which
indicates the flow rate of oxygen.
Turn clockwise to
close cylinder valve
Note: Do not use a humidifier bottle with
a portable system.
• The needle on the pressure gauge will
drop to zero.
Step 3: When the pressure gauge
registers zero, turn the flow selector knob
counterclockwise so that the “0” position is
visible in the flow selector window.
Operating Your Portable Cylinder
System
Your Portable Cylinder System
Attaching the Regulator to a
Full Cylinder
Your portable cylinder system consists
of a cylinder, which stores the pressurized
oxygen, and a regulator, which controls
the flow of oxygen from the cylinder.
In addition, there is a special washer
that fits between the regulator and
the cylinder which prevents the
oxygen from leaking out of the cylinder
when the regulator is attached.
The following step-by-step instructions will help
you operate your portable cylinder system.
To attach the regulator, follow these steps:
Step 1: Wash hands. (See page 4.)
Regulator
Cylinder
Caution: It is very important that
the proper washer be used at all
times. Only use the washer provided.
If you have lost or cannot find the
washer, contact Apria Healthcare
immediately for a replacement.
Pressure Gauge
Nipple
Outlet
Portable cylinder with cart
OXYGEN CYLINDER AND CONCENTRATOR SYSTEMS
Flow
Selector
Regulator on a
portable oxygen cylinder
9
Tee Screw
Replace the washer, if needed
(Step 5)
Install the regulator (Step 6)
Caution: Make sure the valve opening is
not directed at yourself or anyone else
when opening the cylinder.
Step 2: Slowly remove any protective tape.
Using only the cylinder wrench provided,
open the cylinder valve slightly by turning
counterclockwise. This will blow off any dust
in the orifice of the cylinder outlet. Close the
valve tightly.
Step 3: Make sure valve system is free of all
debris and oil.
Step 4: Inspect the regulator and make sure
that the washer is in place before attempting
to place the regulator on the cylinder. If the
washer is missing or is deformed, damaged,
or broken, it needs to be replaced before
the cylinder and regulator can be used. Call
Apria Healthcare immediately
for a replacement. DO NOT use
the regulator with a missing or
damaged washer.
Step 5: If the washer needs to
be replaced, remove the old
washer and replace it with a
new one. Do not use any sharp
instruments (e.g., knife) to remove
the old washer; sharp instruments
10
Hand tighten the tee screw (Step 7)
could scratch the regulator and cause an
oxygen leak.
Step 6: Slip the regulator over the cylinder
valve and neck of the full cylinder. Line up the
pins on the regulator with the holes on the
neck of the cylinder.
Step 7: Hand tighten the tee screw by
turning clockwise.
Step 8: Slowly open the cylinder valve
by turning the nut at the top of the valve
counterclockwise. Never open the valve
rapidly. Your system may require the use of
a cylinder wrench. If there is a leak you may
hear a hissing sound. Tighten the tee screw to
secure the connection. If the leak persists, the
washer may be damaged and may need to be
replaced. Call Apria Healthcare if you need a
replacement washer.
Then see Step 5 for
replacing the washer.
If the leak persists,
call Apria Healthcare.
Step 9: Attach the
oxygen tubing to the
nipple outlet.
Turn counterclockwise to open
the cylinder valve (Step 8)
APRIA HEALTHCARE PATIENT/CAREGIVER INSTRUCTIONS
Turning On Your Oxygen
To turn on your portable cylinder system,
follow these steps:
Step 1: Slowly open the cylinder valve
by turning the nut at the top of the
valve counterclockwise. Never open the
valve rapidly. You may have to use a
cylinder wrench.
Step 1: Remove the nasal cannula or
oxygen mask.
Step 2: Close the cylinder valve by turning
clockwise until snug. (Do not overtighten.)
Your system may require the use of a
cylinder wrench.
• This stops the flow of oxygen from
the cylinder.
The needle on the pressure gauge will
register the amount of oxygen in the cylinder.
A cylinder shows approximately 2,000 PSI on
the gauge.
Step 2: Turn the flow selector knob until the
number that is visible in the flow selector
window is your prescribed flow rate number.
Your physician has prescribed the oxygen rate
for you. Never change this flow rate without
instructions from your physician.
Step 3: Fit the nasal cannula or oxygen mask
to your face so that it is comfortable. See
page 8 for more instructions on placement.
Turning Off Your Oxygen
When you are finished using your oxygen,
turn off your portable cylinder system using
the instructions in the following steps:
• The needle on the pressure gauge will
drop to zero.
Step 3: When the pressure gauge
registers zero, turn the flow selector knob
counterclockwise so that the “0” position is
visible in the flow selector window.
Oxygen Cylinder Supply Times
Your oxygen flow is measured in liters per
minute (LPM).
Average oxygen usage time is based on
continuous flow rate.
The figures in the charts on pages 12–13
are approximate and are to be used only
as a general guide. Individual usage time
will vary.
Flow Selector
Window
Flow
Selector
Knob
Pressure gauge on regulator
Turn flow selector knob
to adjust oxygen flow
(Step 2, Turning On Your Oxygen)
OXYGEN CYLINDER AND CONCENTRATOR SYSTEMS
Turn clockwise to close
cylinder valve
(Step 2, Turning Off Your Oxygen)
11
Adult Cylinder Supply Time Guide
Liter Flow per Minute
PRESSURE GAUGE
READING
1
2000 psi
1500 psi
2
4
5
1 hr.
Not recommended
50 min.
45 min.
Not recommended
30 min.
20 min.
Not recommended
5 min.
0
Not recommended
3 hrs.
2 hrs.
1 hr./30 min.
Approximate Time Remaining:
5 hrs.
D Cylinder
2 hrs.
1 hr./15 min.
3 hrs./30 min. 1 hr./30 min.
1000 psi
2 hrs.
500 psi
1 hr.
2000 psi
9 hrs.
1500 psi
7 hrs.
3 hrs.
2 hrs.
1 hr./30 min.
1 hr.
1000 psi
4 hrs./30 min.
2 hrs.
1 hr./15 min.
1 hr.
30 min.
500 psi
2 hrs.
15 min.
5 min.
2200 psi
1 hr.
25 min.
M Cylinder
2 days/9 hrs. 1 day/5 hrs.
19 hrs.
14 hrs.
11 hrs.
1650 psi
1 day/19 hrs.
22 hrs.
14 hrs.
11 hrs.
9 hrs.
1100 psi
1 day/5 hrs.
14 hrs.
10 hrs.
7 hrs.
6 hrs.
550 psi
14 hrs.
4 hrs.
3 hrs.
2000 psi
4 days/6 hrs.
1 day
19 hrs.
1500 psi
3 days/3 hrs. 1 day/12 hrs.
1 day
17 hrs.
14 hrs.
1 hr.
15 min.
E Cylinder
4 hrs./30 min.
7 hrs.
5 hrs.
H Cylinder
2 days
1 day/12 hrs.
1000 psi
2 days
1 day
15 hrs.
12 hrs.
9 hrs.
500 psi
1 day
12 hrs.
07 hrs.
6 hrs.
4 hrs.
Replacing Your Cylinder
Step 1: Remove the nasal
cannula or oxygen mask.
Step 2: Close the
cylinder valve by turning
the nut at the top of the
tank clockwise until snug.
(Do not overtighten.)
You may have to use a
cylinder wrench.
12
3
Step 3: When the pressure gauge
registers zero, turn the flow selector knob
counterclockwise until it
is tight, so that the “0”
position is visible in the
flow selector window.
Turn clockwise to close cylinder valve
Step 4: Loosen the
regulator at the tee screw.
If necessary, use the key to
loosen the screw.
APRIA HEALTHCARE PATIENT/CAREGIVER INSTRUCTIONS
Pediatric Cylinder Supply Time Guide
Liter Flow per Minute
PRESSURE GAUGE
READING
1/16
2000 psi
3 days
1/8
1/4
1/2
3/4
9 hrs.
6 hrs.
Approximate Time Remaining:
D Cylinder
1 day/12 hrs.
20 hrs.
1500 psi
2 days/12 hrs. 1 day/6 hrs.
15 hrs.
7 hrs.
4 hrs.
1000 psi
1 day/12 hrs.
18 hrs.
9 hrs.
4 hrs.
3 hrs.
500 psi
18 hrs.
4 hrs.
2 hrs.
1 hr.
2000 psi
6 days
9 hrs.
E Cylinder
3 days
1 day
19 hrs.
12 hrs.
1500 psi
4 days
2 days
1 day
14 hrs.
10 hrs.
1000 psi
3 days
1 day
18 hrs.
9 hrs.
6 hrs.
500 psi
1 day
5 hrs.
3 hrs.
2000 psi
68 days
18 hrs.
9 hrs.
H Cylinder
34 days
17 days
8 days/12 hrs. 5 days/12 hrs.
1500 psi
52 days
26 days
6 days/12 hrs. 4 days/6 hrs.
1000 psi
34 days
17 days
500 psi
16 days
8 days
Step 5: Remove the regulator by lifting it
up over the cylinder valve.
Step 6: Remove the tank seal from the valve
of the new cylinder.
13 days
8 days/12 hrs. 4 days/6 hrs. 2 days/18 hrs.
4 days
2 days
1 day/9 hrs.
Step 8: Replace the regulator as described
on page 7 under “Attaching the Regulator to a
Full Cylinder” for standard cylinder systems, or
on page 9 under “Attaching the Regulator to a
Full Cylinder” for portable cylinder systems.
Caution: Make sure the valve opening
is not directed at yourself
or anyone else when
opening the cylinder.
Step 7: Slowly open the
cylinder valve slightly by
turning counterclockwise.
This will blow off any
dust in the orifice of the
cylinder outlet. Close the
valve tightly.
Remove tank seal from valve
of new cylinder (Step 6)
OXYGEN CYLINDER AND CONCENTRATOR SYSTEMS
Turn counterclockwise to open the
cylinder valve (Step 7)
13
your resupply is
being delivered.
Tee Screw
Tighten the tee screw (Step 9)
Replace the washer, if needed (Step 10)
Step 9: Slowly open the cylinder valve
by turning the nut at the top of the valve
counterclockwise. Never open the valve
rapidly. Your system may require the use of
a cylinder wrench. If there is a leak you may
hear a hissing sound. Tighten the tee screw
to secure the connection. If the leak persists,
the washer may be damaged and may need
to be replaced.
Step 10: If the washer appears to be deformed,
damaged, or broken, it needs to be replaced
before the cylinder and regulator can be used.
Remove the old washer and replace it with
a new one, as shown above. Do not use any
sharp instruments (e.g., knife) to remove the old
washer; sharp instruments could scratch the
regulator and cause an oxygen leak.
If the leak persists, call Apria Healthcare.
Reordering Oxygen
Always be aware of the amount of oxygen
remaining in your cylinder.
You will most likely be on an automatic
redelivery schedule, but always knowing
how much oxygen you have will
prevent any worry of running out while
14
In order to provide
the best possible
service to our oxygen
customers, Apria
has developed the
following oxygen
resupply process.
1) Several days prior to your scheduled
delivery day, you will receive
an automated call from our
scheduling department.
2) Listen to the prompts to confirm
the need for your resupply order.
3) Press “1” to enter the confirmation
queue then press “1” to confirm your
need for a refill, or “2” to decline
your refill order.
4) Declined deliveries will automatically
be set to the next scheduled
delivery day based on your cycle
and frequency.
If you are not on an automatic delivery
schedule, reorder a new cylinder two days
before your cylinder has been calculated to run
out. Please contact the Oxygen Scheduling
Department at 1 (855) 869-9436. Call
this number if you believe you do not have
enough cylinders to make it to your next
scheduled delivery. This will allow Apria
Healthcare to schedule your delivery without
causing you to worry.
Consult the tables on pages 12–13 for oxygen
cylinder supply time guidelines.
APRIA HEALTHCARE PATIENT/CAREGIVER INSTRUCTIONS
Oxygen Cylinder Troubleshooting
Trouble
Probable Cause
Remedy
No oxygen coming
from cannula
or mask
Empty cylinder
Check pressure gauge for oxygen contents.
If cylinder is empty, remove regulator
and attach to new full cylinder. Call Apria
Healthcare for additional oxygen.
Decreased awareness of
oxygen flow
Place cannula prongs in a clean glass of
water. If you observe bubbles coming from
your cannula, your unit is working correctly.
Faulty cannula or mask
Remove cannula or mask and check tubing
for kinks or obstructions. Replace with new
cannula or mask if needed.
Loose connections
Check all connections, especially humidifier
bottle to regulator and humidifier top to
bottle. Be certain the bottle is screwed on
straight. Cross-threading will cause oxygen to
escape out the top of the bottle.
Plugged humidifier
bottle
Remove humidifier bottle. If flow is restored,
clean or replace with new humidifier bottle.
Cylinder valve is closed
or flow selector is “0”
Check cylinder valve to make sure it is open.
Adjust flow selector to prescribed flow rate.
Faulty regulator
Call Apria Healthcare. NEVER attempt to fix
the regulator yourself.
Regulator not attached
tightly
Turn the oxygen off. Check and retighten
connection between regulator and cylinder.
Faulty washer
Replace washer.
Faulty regulator
Call Apria Healthcare. NEVER attempt to fix
the regulator yourself.
Oxygen cylinder
hisses and is
leaking oxygen
All other problems
or questions about
equipment
OXYGEN CYLINDER AND CONCENTRATOR SYSTEMS
Call your Apria Healthcare location.
15
Your Oxygen Concentrator
Where to Place Your
Concentrator
An oxygen concentrator
Flow Selector
Alarm System
Place your concentrator in a
is an electrically
well-ventilated area, away from
operated device that
fireplaces, the stove, any open
draws in room air,
flames, any heat source or heat
separates the oxygen
vent. Do not place it in a closet.
from the other gases
Place it at least 12 inches from
in the air and delivers
any drapes, bedding, walls or any
the concentrated
other item that may block the inlet
oxygen to you. The
ports. If the concentrator is too
concentrator acts like a
noisy, place it in an adjacent room
strainer. It traps oxygen
but make sure that the alarm
and releases the other
Humidifier Bottle
Power
is still audible to the patient
gases (mostly nitrogen)
(optional)
Switch
or caregiver.
back into the room air.
Typical oxygen concentrator
This process goes on
continuously until the oxygen inside the
Operating Your Oxygen
unit is highly concentrated. At two liters per
Concentrator
minute, the air which you receive from your
concentrator is more than 90 percent oxygen.
The following step-by-step instructions will
Oxygen concentrators are available in
different sizes and models. However,
all models have the same basic parts:
a power switch to turn the unit on and off,
a flow selector that regulates the amount
of oxygen you receive and an alarm system
that alerts you if the power is interrupted.
The oxygen is delivered to you through a
nasal cannula or face mask. The tubing on
the cannula or mask is attached to the outlet
on the unit. Sometimes, an extra length
of tubing may be provided. This will allow
you to move a farther distance from
your concentrator, but the overall tubing
length should not be longer than 50 feet
(not including the length of the cannula).
16
help you operate your oxygen concentrator.
Step 1: Insert the power plug into a nearby
power outlet.
Note: Most Apria oxygen concentrators
use “2-prong” power plugs and do
not require a 3-prong, grounded AC
power outlet.
Two-prong power plug
Three-prong (grounded)
power plug
However, if the equipment that has been
provided to you has a 3-prong power plug
and your home does not have 3-prong power
outlets, your patient service technician will
APRIA HEALTHCARE PATIENT/CAREGIVER INSTRUCTIONS
ON position. The alarm will
sound for a few seconds
until the proper pressure
is reached.
Step 5: Adjust the oxygen
flow rate by turning the
flow selector knob until the
middle of the indicator ball is
at the prescribed number.
Attach humidifier bottle (Step 3)
Use flow selector knob to adjust
oxygen flow rate (Step 5)
exchange your concentrator for a unit
that utilizes the 2-prong plug.
• Your physician has
prescribed the oxygen
flow rate for you.
• Never change this oxygen flow rate
without instructions from your physician.
Step 2: Attach the oxygen tubing to the
nipple outlet on the concentrator.
Step 6: Fit the nasal cannula or the oxygen
mask to your face so that it is comfortable.
Step 3: If a humidifier bottle is recommended,
attach a filled humidifier bottle.
Nasal Cannula:
• Center the threaded cap on the
humidifier bottle under the threaded
outlet tube on the concentrator.
• Turn the cap on the humidifier bottle
until it is tightly screwed onto the outlet
tube. Be certain the bottle is screwed
on straight. Cross-threading will cause
oxygen to escape out the top of
the bottle.
• Insert the two prongs of the cannula into
your nostrils. Make sure the prongs face
upward and curve into your nostrils.
• Slide the tubing over and behind
each ear.
• Adjust the tubing to fit comfortably
under your chin by sliding the adjuster
upward. Be careful not to adjust it
too tightly.
• Attach oxygen tubing to the nipple
outlet on the humidifier bottle.
Note: Humidifier bottles are generally
recommended only for patients using
flow rates greater than four liters
per minute.
Step 4: Press the ON/OFF switch to the
OXYGEN CYLINDER AND CONCENTRATOR SYSTEMS
Adjust nasal cannula
Adjust oxygen mask
17
Oxygen Mask
• Place the oxygen mask over your mouth
and nose.
• Slide the loose elastic strap over your
head and position it above your ears.
• Pull the end of the elastic on each side of
the mask until the mask fits comfortably.
• Pinch the metal nose strap to fit snugly
around your nose. This will prevent
oxygen from blowing into your eyes.
Note: Do not use an oxygen mask if your
physician prescribed a nasal cannula.
Oxygen masks must only be used with liter
flow rates of five liters (or more) per minute.
Use your concentrator for the number of hours
each day which your physician has prescribed.
Step 7: When you have finished using your
oxygen, always:
a damp cloth. See below for filter maintenance
and humidifier bottle care.
Cleaning and decontamination of respiratory
therapy equipment in the home is of
major concern. To prevent equipment
contamination, a simple but effective
cleaning procedure must be carried out on a
routine basis. Do all cleaning and disinfecting
in a clean environment. Avoid doing it after
vacuuming, under an open window, or in
dusty, dirty, smoky areas.
Filter Cleaning and Maintenance
The external filter requires cleaning once
a week.
Step 1: Remove the filter.
Step 2: Wash it in a solution of warm water
and a clear liquid detergent.
• Remove the nasal cannula or
oxygen mask.
Step 3: Rinse the filter thoroughly with
warm water.
• Turn the ON/OFF switch to the
OFF position.
Step 4: Gently squeeze water from the filter,
then pat it dry with a clean towel.
Cleaning and Maintenance
Procedures
Step 5: Once the filter is completely dry,
reattach the filter.
All Cleaning Must
Be Done in a Clean
Environment
The external filter, humidifier
bottle and cabinet require
periodic cleaning. The
cabinet can be washed with
Remove the filter from the concentrator
18
Wash the filter once a week
APRIA HEALTHCARE PATIENT/CAREGIVER INSTRUCTIONS
Step 7: Screw the bottle back
on the humidifier bottle lid
until it is tight. Be certain the
bottle is screwed on straight.
Cross-threading will cause
oxygen to escape out the top
of the bottle.
Rinse bottle under a strong
stream of warm tap water
Refill bottle with distilled water
to the fill line
Care of Your Humidifier Bottle
If you are using a humidifier bottle with your
oxygen concentrator, you will need to check
the water level in the bottle frequently. When
the water runs low or the bubbling stops,
you need to refill the bottle. Always use your
back-up oxygen system while refilling and
cleaning your humidifier bottle.
Refilling the Humidifier Bottle
Step 1: Wash your hands as instructed on
page 4.
Step 2: Turn the oxygen concentrator off.
Step 3: Unscrew the bottle from the
humidifier bottle lid.
Step 4: Discard any water remaining in
the bottle.
Step 5: Rinse bottle under a strong stream of
warm tap water. Shake off the excess water.
Step 6: Refill the bottle with distilled water
to the fill line. Do not overfill the bottle. Too
much water in the bottle will cause water to
collect in your oxygen tubing.
OXYGEN CYLINDER AND CONCENTRATOR SYSTEMS
Twice Weekly Cleaning
and Disinfection
It is very important to clean
your humidifier bottle to
prevent infection. The following procedure
should be done twice a week:
Step 1: Wash your hands as instructed on
page 4.
Step 2: Turn the oxygen concentrator off.
Step 3: Remove the humidifier bottle.
Step 4: Wash the entire humidifier bottle in a
solution of liquid detergent and warm water.
Step 5: Rinse the bottle thoroughly. Shake off
the excess water.
Step 6: Mix together one part white vinegar
and one part water.
Step 7: Soak the entire humidifier bottle for
30 minutes in the vinegar solution.
Step 8: Take the humidifier bottle out of the
solution and rinse in warm tap water.
Step 9: Allow the humidifier bottle to air dry.
Step 10: Discard the vinegar solution.
Step 11: Replace your humidifier bottle
as instructed above.
19
Oxygen Concentrator Troubleshooting
Trouble
Probable Cause
Remedy
No oxygen seems
to be flowing from
your system
Cannula or nipple
adapter not connected
tightly
Place the end of your cannula in a small glass
of water and look for a steady flow of bubbles.
If you can see the bubbles, your oxygen
system is working fine.
If you can’t see any bubbles coming from
both of your cannula prongs or if the bubbles
have decreased in volume, check to see that
the cannula is connected tightly to your
oxygen system and that the nipple adapter
is screwed on tightly.
If using a humidifier, make sure that the lid is
screwed on tightly and is not cross threaded.
Water blocking the
oxygen tubing
Overfilling your
humidifier bottle,
or tubing that is lying
on a cold floor
You should use your back-up oxygen system
while attending to water in your tubing.
Unit not operating
(power failure
alarm sounds)
Plug not firmly in wall
Check plug at outlet.
Concentrator circuit
breaker has been set off
Press reset button.
No power at wall outlet
Check power source (fuse or circuit breaker).
Wall switch that controls plug may be
switched off. Try another outlet.
Electrical power outage
Use back-up oxygen system until power
is restored.
Obstructed humidifier
bottle
Disconnect humidifier bottle. If flow is
restored, replace with new humidifier bottle
or use a nipple adapter.
Obstruction in tubing
Disconnect tubing. If flow rate is restored,
replace with new tubing.
Obstruction in cannula
Disconnect cannula from tubing. If proper flow
rate is restored, replace with a new cannula.
Unable to dial
prescribed flow rate
20
APRIA HEALTHCARE PATIENT/CAREGIVER INSTRUCTIONS
Oxygen Concentrator Troubleshooting
(Continued)
Trouble
Probable Cause
Remedy
Temperature light/
alarm is on
Unit overheated
Check to see that unit is not obstructed by
drapes, bedspread, wall, etc.
Check to see that filters are clean.
Turn unit off and go to your back-up system
for 30 minutes while your concentrator is
cooling. Restart your concentrator.
All other problems
or alarms
Travel Tips
Early planning and careful preparation are the
keys to an enjoyable trip. The following tips
should help you plan and prepare for any trip.
• Contact your physician to make sure
your proposed trip is medically safe
and to obtain additional copies of
your prescription.
• Contact Apria Healthcare for assistance
with getting oxygen refills along your
driving route or at your final destination.
Apria offers its Great Escapes™ program
to assist with your travel arrangements.
Contact Apria’s Great Escapes National
Travel Department at least six weeks
prior to your travel date by calling us
at 1 (888) 492-7742 and selecting the
Travel Department.
• Have a check, money order or credit
card available to pay for oxygen refills or
equipment. Cash is not accepted.
OXYGEN CYLINDER AND CONCENTRATOR SYSTEMS
Contact Apria Healthcare.
If traveling by car or recreational
vehicle:
• Remind passengers not to smoke in
the vehicle in which you are traveling.
• Secure all cylinders in a manner that
prevents them from moving within
the vehicle. Cylinders may be stored
upright or lying down as long as they
are secure.
• Keep one window partially open to
provide proper ventilation.
• Do not store oxygen in the trunk of
your car.
• Do not store oxygen in an area where
the internal or external temperature
could reach 120 degrees Fahrenheit.
• When traveling in, or occupying a
recreational vehicle, do not store
oxygen near LP cylinders, LP tanks,
or an open flame.
• Stay at least 5 feet away from all
open flames, such as camp stoves,
lanterns, and heaters.
21
If traveling by bus, train or ship:
• Contact the reservation office for specific
information about the use of oxygen
and special accommodations.
• Make sure to contact Apria at least
four weeks in advance. There may be
additional documentation, forms or
releases required. There may also be
additional fees required.
If traveling by airplane:
• Visit our website at apria.com, select
Apria’s Travel Support, then select
Portable Oxygen Concentrator request
form. Print this form, complete the
patient page and have your physician
complete the physician’s page. Return
these completed pages to your local
Apria branch at least three to four
weeks before your departure date.
• Many airlines also have forms that need
to be completed by your physician. You
should contact your airline provider to
advise them that you will be travelling
with oxygen and get any forms that
they require.
• Request a direct flight, if one is available.
• Apria Healthcare offers its Great
Escapes program to assist with your
travel arrangements. Contact Apria
Healthcare’s Great Escapes National
Travel Department at least six weeks
prior to your travel date by calling us
at 1 (888) 492-7742 and selecting the
Travel Department.
• Most airlines allow patients to bring
portable oxygen concentrators on board.
22
As part of Apria Great Escapes travel
program, Apria can provide most patients
with a portable oxygen concentrator
that is allowed on most airlines.
• Before you depart on a plane, ensure
that arrangements have been made to
obtain oxygen at your final destination.
For further information, please contact Apria
Healthcare’s Great Escapes National Travel
Department at 1 (888) 492-7742, then select
the Travel Department.
Feedback on Our Services
Apria Healthcare is among America’s most
experienced and respected home respiratory
care providers, and our patient satisfaction
scores are consistently high. It is possible,
however, that you may have a concern and
we welcome feedback. To voice a concern,
you should take these steps:
1. Call the Apria Customer Service
Department at 1 (888) 492-7742
OR
2. Contact us by e-mail at:
[email protected]
OR
3. Visit our web site at apria.com
Satisfaction Survey Process
Our goal is to ensure your satisfaction. You
will likely receive an Apria patient satisfaction
questionnaire and we hope that you will take
a few minutes to fill it out and return it to us.
The postage is prepaid by Apria Healthcare.
APRIA HEALTHCARE PATIENT/CAREGIVER INSTRUCTIONS
Did you know that Apria Healthcare currently provides
a home ventilator that can be used with a face or nasal mask?
It’s called non-invasive ventilation
Non-invasive ventilation is prescribed for
patients with Chronic Respiratory Failure
caused by severe Chronic Obstructive
Pulmonary Disease (COPD) as well as other
conditions that may result in a patient needing
extra assistance with breathing.
Patients who benefit from non-invasive
ventilation therapy typically have been
diagnosed with severe COPD. They often have
difficulty performing everyday activities due
to shortness of breath; and this happens even
though they may already be on oxygen therapy
and/or using inhaled respiratory medications.
Are you a COPD patient who needs help to
breathe easier?
Ask your doctor or your local Apria branch
for more information. Certain qualification
requirements do apply, and not all patients
with COPD will require non-invasive ventilation.
What does COPD mean?
Chronic Obstructive Pulmonary
Disease (COPD) is an umbrella term
used to describe progressive lung
diseases including emphysema,
chronic bronchitis, refractory
(non-reversible) asthma, and some
forms of bronchiectasis.
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